{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T08:59:45Z","timestamp":1777021185981,"version":"3.51.4"},"reference-count":45,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2016,10,25]],"date-time":"2016-10-25T00:00:00Z","timestamp":1477353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Lung transplant (<jats:styled-content style=\"fixed-case\">LTX<\/jats:styled-content>) recipients are at high risk of invasive Aspergillus infections (<jats:styled-content style=\"fixed-case\">IAI<\/jats:styled-content>). However, no randomized\u2010controlled trials (<jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>) or international guidelines on antifungal prophylaxis (<jats:styled-content style=\"fixed-case\">AFP<\/jats:styled-content>) in the <jats:styled-content style=\"fixed-case\">LTX<\/jats:styled-content> population exist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A meta\u2010analysis was performed to determine whether <jats:styled-content style=\"fixed-case\">AFP<\/jats:styled-content> reduces the rate of <jats:styled-content style=\"fixed-case\">IAI<\/jats:styled-content> after <jats:styled-content style=\"fixed-case\">LTX<\/jats:styled-content>. A total of six eligible observational studies (five with no prophylaxis, one with targeted prophylaxis, three studies including heart\/lung transplantation) with a total of 748 patients were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The pooled odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) for <jats:styled-content style=\"fixed-case\">IAI<\/jats:styled-content> (62 <jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content> in the intervention arm and 82 in the control group) was 0.234 (95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 0.097\u20100.564, <jats:italic>P<\/jats:italic>=0.001, <jats:italic>z<\/jats:italic>=\u22123.237). Pooled studies were characterized by substantial heterogeneity (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>=66.64%); number needed to treat was 6.8. A subgroup analyses with exclusion of heart transplant recipients also showed a statistically significant reduction in <jats:styled-content style=\"fixed-case\">IAI<\/jats:styled-content> with <jats:styled-content style=\"fixed-case\">AFP<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.183, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.0449\u20100.744, <jats:italic>P<\/jats:italic>=0.018).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study suggests that universal antifungal prophylaxes reduces incidence of <jats:styled-content style=\"fixed-case\">IAI<\/jats:styled-content> after <jats:styled-content style=\"fixed-case\">LTX<\/jats:styled-content>. However, included studies are limited by small sample size, single\u2010center structure without randomization, mixed population (including heart\/heart\u2010lung transplant), and heterogeneity due to variations in immunosuppression, type, and duration of AFP. Therefore, there is a clear need for an adequately powered <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.12854","type":"journal-article","created":{"date-parts":[[2016,9,21]],"date-time":"2016-09-21T17:36:43Z","timestamp":1474479403000},"page":"1522-1531","source":"Crossref","is-referenced-by-count":36,"title":["Is universal antifungal prophylaxis mandatory in adults after lung transplantation? 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Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henning","family":"Carstens","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery West German Heart and Vascular Center Essen University Hospital Essen  Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Assad","family":"Haneya","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery University of Schleswig\u2010Holstein  Kiel Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jochen","family":"Cremer","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery University of Schleswig\u2010Holstein  Kiel Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heinz","family":"Jakob","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery West German Heart and Vascular Center Essen University Hospital Essen  Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaus","family":"Pizanis","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery West German Heart and Vascular Center Essen University Hospital Essen  Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Kamler","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery West German Heart and Vascular Center Essen University Hospital Essen  Essen 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